Systematic review and case report: Intracranial complications of pediatric sinusitis

Patel, Neha A.; Garber, David; Hu, Shirley; Kamat, Ameet

doi:10.1016/j.ijporl.2016.05.009

Cited by 81 publications

(89 citation statements)

References 25 publications

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“…The most favourable surgical treatment is yet to be established 11. Smaller studies have demonstrated successful operations of epidural abscesses with an endoscopic transnasal approach, while subdural empyema, to a larger extent, needs craniotomy or burr hole aspiration 19…”

Section: Discussionmentioning

confidence: 99%

Sinogenic intracranial complications: is adalimumab a culprit?

Kofoed

Fisker²,

Christensen³

et al. 2018

BMJ Case Reports

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We present two 11-year-old girls with chronic recurrent multifocal osteomyelitis, treated with adalimumab. Both developed severe intracranial complications to sinusitis. Patient 1 had been treated with adalimumab for 15 months when she developed acute sinusitis complicated by an orbital abscess, forehead swelling, a subdural empyema and osteomyelitis of the frontal bone. She was treated with a rhinosurgical and neurosurgical approach with intravenous antibiotics.Patient 2 had been in adalimumab treatment for 10 weeks. Adalimumab was discontinued 8 weeks prior to developing subdural empyema and subcortical abscesses in combination with sinusitis. She was treated with endoscopic sinus surgery and intravenous antibiotics. Both patients had developed psoriasis and episodes of infection during treatment. They were non-septic and had low fever on presentation. None of the patients suffered any long-term neurological sequelae. The immunosuppressive treatment with adalimumab is considered to be the cause of the sinogenic intracranial complications in our cases.

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Section: Discussionmentioning

confidence: 99%

Sinogenic intracranial complications: is adalimumab a culprit?

Kofoed

Fisker²,

Christensen³

et al. 2018

BMJ Case Reports

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“…These findings are in accordance with our reported cases. However, the reason for this tendency of the majority of patients being young ad- olescent males is still unknown [8]. The presentation of such intracranial complications is due to the spread of the organism from infected sinuses through septic thrombophlebitis of the emissary veins, which bridge the superficial cranial venous drainage and the intracranial venous system.…”

Section: Discussionmentioning

confidence: 99%

“…It is important to recognize intracranial complications which require immediate medical and surgical intervention. Various reported cases of pediatric subdural empyema with clinical profile, site of empyema, treatment, and outcome are summarized in Table 1 [1,8,11,24,25].…”

Section: Discussionmentioning

confidence: 99%

Interhemispheric and Infratentorial Subdural Empyema with Preseptal Cellulitis as Complications of Sinusitis: A Case Report

et al. 2017

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Intracranial complications of paranasal sinusitis have become rare due to the use of antibiotics nowadays. However, several cases have been reported due the ability of paranasal sinusitis to cause serious complications. Once the infection spreads over the cranial structure, it could infect the orbits, underlying bones, meninges, adjacent veins, and brain. Subdural empyema is a rare but potentially life-threatening complication following paranasal sinusitis and should be considered as a neurological emergency. The location where subdural empyema may appear is a challenge in diagnosis and treatment. We report the case of a 17-year-old boy who presented in a state of somnolence due to interhemispheric and infratentorial subdural empyema with preseptal cellulitis secondary to pansinusitis. Early diagnosis and aggressive antibiotic treatment combined with neurosurgical operation were mandatorily implemented. The case was managed using a multidisciplinary approach including the ENT, eye, and nutrition departments. The boy achieved clinical improvement, with impairment of eye movement as the only persistent symptom before discharge. Daily supervision at the primary health care center with continuous antibiotic treatment was recommended to the patient. Pertinent literature with controversies in the management of subdural empyema will be briefly discussed in this case report.

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“…Além disso, em crianças, as complicações geralmente advêm de um processo agudo (rinossinusite aguda -RSA), ao passo que, em adultos, as complicações estão mais comumente associadas a episódios de rinossinusite crônica (RSC). 1,14 A evolução da antibioticoterapia ocorrida nas últimas décadas reduziu drasticamente a morbimortalidade associada às complicações das RS. Entretanto, é interessante observar que não houve nenhuma alteração na incidência das complicações das RS.…”

Section: Epidemiologiaunclassified

“…A TC mostra uma lesão em aspecto de crescente, que não respeita a linha média. 1,3,5,14 Abscesso cerebral e cerebrite -ocorre mais frequentemente na região do lobo frontal. O diagnostico geralmente é tardio, percebido somente quando advém febre, sinais de hipertensão intracraniana, crise convulsiva, alterações do nível de consciência e/ou sinais neurológicos focais.…”

Section: 5unclassified

Complicações das rinossinusites

Marconato¹,

Mangussi‐Gomes

Balsalobre

2017

Revista HUPE

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Introdução: As complicações das rinossinusites (RS) incluem uma série de doenças que necessitam de reconhecimento e tratamento imediatos. A literatura descreve várias formas de classificação e definição destas doenças. Objetivos: Descrever aspectos epidemiológicos e fisiopatológicos das complicações das rinossinusites. Métodos: Revisão narrativa utilizando artigos recentes e históricos que norteiam nossa conduta e são utilizados como base dos tratamentos atuais. Resultados: Dentre as complicações das RS, as que mais se destacam pela frequência são as orbitárias, responsáveis por até 75% dos casos, principalmente em crianças. Além das orbitárias, podem ocorrer ainda as complicações ósseas e cerebrais, constituindo um grande desafio, tanto pela sua dificuldade diagnóstica, como pelos altos índices de morbimortalidade. Conclusão: Independente do tipo de complicação, deve-se sempre ter em mente esses diagnósticos diferenciais a fim de se iniciar o tratamento específico o mais precocemente possível e evitar desfechos desfavoráveis. Descritores:Complicações; Sinusite; Abscesso; Celulite orbitária; Empiema subdural. Abstract Rhinosinusitis complicationsIntroduction: The rhinosinusitis (RS) complications include a range of diseases that require immediate recognition and treatment. The literature describes several ways of classifying and defining them. Objectives: To describe epidemiologic and fisiologic aspects of the RS complications. Method: Narrative review using recent and historical articles that guide our conduct and are the basis of current treatments. Results: Among the complications of RS, the most frequent are the orbital, responsible for 75% of cases, mainly in children. Besides the orbital, there are bone and brain complications, constituting a great challenge, as much for diagnostic difficulty as for high morbidity and mortality rates. Conclusions: Despite the complication, it is important to keep in mind these differential diagnoses in order to provide the specific treatment soon as possible and avoid unfavorable outcomes.

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Systematic review and case report: Intracranial complications of pediatric sinusitis

Cited by 81 publications

References 25 publications

Sinogenic intracranial complications: is adalimumab a culprit?

Sinogenic intracranial complications: is adalimumab a culprit?

Interhemispheric and Infratentorial Subdural Empyema with Preseptal Cellulitis as Complications of Sinusitis: A Case Report

Complicações das rinossinusites

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